Benjamin Feiner1, Lieke Gietelink, Christopher Maher. 1. Division of Urogynaecology and reconstructive pelvic surgery, Royal Women's, Mater and Wesley Hospitals, Brisbane, Queensland, Australia. feiner@tx.technion.ac.il
Abstract
INTRODUCTION AND HYPOTHESIS: The surgical management of multi-compartment prolapse is challenging and often requires a combination of techniques. This study evaluates anterior vaginal mesh repair, sacrospinous hysteropexy and posterior fascial plication in women with anterior compartment dominated uterovaginal prolapse. METHODS: Consecutive women who underwent the aforementioned surgery were prospectively evaluated. Main outcome measures included objective (pelvic organ prolapse quantification stage <2) and subjective success rates, patient satisfaction, functional outcomes and complications. RESULTS: One hundred and seventeen women were eligible, and 100 agreed to participate. At 12 months, objective success rate at the anterior compartment was 87% and at all compartments, 75%. Subjective success was 84%, and mean patient satisfaction was 8.5/10. There were no stage 3 or 4 recurrences at any site. CONCLUSIONS: The combination of anterior vaginal mesh, sacrospinous hysteropexy and posterior fascial plication is reasonably effective in restoring the anatomy and achieving favourable bladder, bowel and sexual function.
INTRODUCTION AND HYPOTHESIS: The surgical management of multi-compartment prolapse is challenging and often requires a combination of techniques. This study evaluates anterior vaginal mesh repair, sacrospinous hysteropexy and posterior fascial plication in women with anterior compartment dominated uterovaginal prolapse. METHODS: Consecutive women who underwent the aforementioned surgery were prospectively evaluated. Main outcome measures included objective (pelvic organ prolapse quantification stage <2) and subjective success rates, patient satisfaction, functional outcomes and complications. RESULTS: One hundred and seventeen women were eligible, and 100 agreed to participate. At 12 months, objective success rate at the anterior compartment was 87% and at all compartments, 75%. Subjective success was 84%, and mean patient satisfaction was 8.5/10. There were no stage 3 or 4 recurrences at any site. CONCLUSIONS: The combination of anterior vaginal mesh, sacrospinous hysteropexy and posterior fascial plication is reasonably effective in restoring the anatomy and achieving favourable bladder, bowel and sexual function.
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